Factors influencing health professionals' management of tracheal intubation in oral and maxillofacial malignancies patients after surgery: A qualitative study

Abstract

Background Tracheal intubation is significant for patients with Oral and maxillofacial malignancies (OMMs) after surgery. Despite the development of practice guidelines and training programs, the current management of tracheal intubation by healthcare professionals (HCPs) is inadequate. This study aimed to explore factors that hinder HCPs in managing the tracheal intubation of patients with OMMs after surgery in the intensive care unit (ICU). Methods Semi-structured interviews were conducted with 12 experienced HCPs in three clinical units at a tertiary hospital in Shanghai, China, from February to May 2024. Purposive sampling was used. The data were organized and analyzed using NVivo 12.0 software and Braun and Clarke's reflective thematic analysis. Results Two themes and seven sub-themes emerged: (1) institutional factors: lack of a risk assessment system for airway obstruction, lack of a tracheal intubation emergency team, preparations for delayed extubation were inconsistent, and inadequate reintubation training for airway obstruction, and (2) individual factors: normativity of airway humidification, reserve of knowledge on the risk of airway obstruction, and attitude about learning about airway obstruction. Conclusion HCPs' inadequate management of tracheal intubation in patients with OMMs after surgery is influenced by multiple factors. Designing targeted interventions utilizing these influencing factors will improve HCPs' ability to manage tracheal intubation and ensure the life safety and effective treatment of patients with OMMs following surgery.